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Liver transplantation: MR angiography with surgical validation
J P Finn1, R R Edelman, R L Jenkins
1Department of Radiology, New England Deaconess Hospital, Boston, MA 02215.
Radiology
|April 1, 1991
Summary
Magnetic resonance angiography accurately assesses the portal system before liver transplantation. This imaging technique is valuable for preoperative evaluation, detecting issues like portal vein occlusion and varices.
Area of Science:
- Radiology
- Vascular Imaging
- Hepatology
Background:
- Preoperative assessment of the portal system is crucial for liver transplantation success.
- Accurate imaging of portal vein patency and collateral circulation is essential.
Purpose of the Study:
- To evaluate the diagnostic accuracy of magnetic resonance (MR) angiography in assessing the portal system.
- To determine the utility of MR angiography in the preoperative evaluation of liver transplant candidates.
Main Methods:
- Thirty patients undergoing evaluation for liver transplantation were included.
- Three-dimensional projection angiograms were created from breath-hold, two-dimensional MR images.
- Presaturation bolus tracking assessed portal vein blood flow; duplex ultrasound and surgical/autopsy correlation were used for comparison.
Main Results:
- MR angiography demonstrated portal vein patency in 96% of patients and accurately diagnosed portal venous occlusion in all affected cases.
- The technique depicted reversed portal flow in one patient and clearly delineated varices and portosystemic collaterals.
- MR findings showed full agreement with duplex ultrasound (when successful) and were fully corroborated by surgical or autopsy data.
Conclusions:
- MR angiography is highly accurate for evaluating the portal system in patients considered for liver transplantation.
- This imaging modality is a valuable tool for preoperative assessment, aiding in surgical planning and patient selection.